Tim Charles Foulke, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

080045508N6 Issued in OR

Practice address

2015 NE 39TH Ave
Portland, OR 97212-5305

Phone

(503) 422-3253

Fax

(503) 281-0052

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tim Foulke Ms, Pmhnp PC

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1497906721
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265572937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 NE 36TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125241",
            "telephone_number": "503-284-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 NE 39TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125305",
            "telephone_number": "503-422-3253",
            "fax_number": "503-281-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOULKE",
        "first_name": "TIM",
        "middle_name": "CHARLES",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "080045508N6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Foster, MSW, LCSW
• Zachary Foster
• Paula Lynn Fothergill, M.S., CADCII
• Sara K Foto, LPC
• Lorraine Ellen Fouch, CADCI
• Foundations Behavioral Center
• Foundations Clinic, LLC
• Foundations Pediatric Therapy, LLC
• Marie-Pierre Fournier-Gosselin, M.D.
• Jamie Kay Fournier, PEER SUPPORT SPECIAL

• All providers in Portland, OR
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.